Tag: statistics

J Magn Reson Imaging. 2022 Feb 7. doi: 10.1002/jmri.28098. Online ahead of print.

ABSTRACT

BACKGROUND: Quantitative imaging studies of the pancreas have often targeted the three main anatomical segments, head, body, and tail, using manual region of interest strategies to assess geographic heterogeneity. Existing automated analyses have implemented whole-organ segmentation, providing overall quantification but failing to address spatial heterogeneity.

PURPOSE: To develop and validate an automated method for pancreas segmentation into head, body, and tail subregions in abdominal MRI.

STUDY TYPE: Retrospective.

SUBJECTS: One hundred and fifty nominally healthy subjects from UK Biobank (100 subjects for method development and 50 subjects for validation). A separate 390 UK Biobank triples of subjects including type 2 diabetes mellitus (T2DM) subjects and matched nondiabetics.

FIELD STRENGTH/SEQUENCE: A 1.5 T, three-dimensional two-point Dixon sequence (for segmentation and volume assessment) and a two-dimensional axial multiecho gradient-recalled echo sequence.

ASSESSMENT: Pancreas segments were annotated by four raters on the validation cohort. Intrarater agreement and interrater agreement were reported using Dice overlap (Dice similarity coefficient [DSC]). A segmentation method based on template registration was developed and evaluated against annotations. Results on regional pancreatic fat assessment are also presented, by intersecting the three-dimensional parts segmentation with one available proton density fat fraction (PDFF) image.

STATISTICAL TEST: Wilcoxon signed rank test and Mann-Whitney U-test for comparisons. DSC and volume differences for evaluation. A P value < 0.05 was considered statistically significant.

RESULTS: Good intrarater (DSC mean, head: 0.982, body: 0.940, tail: 0.961) agreement and interrater (DSC mean, head: 0.968, body: 0.905, tail: 0.943) agreement were observed. No differences (DSC, head: P = 0.4358, body: P = 0.0992, tail: P = 0.1080) were observed between the manual annotations and our method’s segmentations (DSC mean, head: 0.965, body: 0.893, tail: 0.934). Pancreatic body PDFF was different between T2DM and nondiabetics matched by body mass index.

DATA CONCLUSION: The developed segmentation’s performance was no different from manual annotations. Application on type 2 diabetes subjects showed potential for assessing pancreatic disease heterogeneity.

LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY STAGE: 3.

PMID:35128748 | DOI:10.1002/jmri.28098

J Magn Reson Imaging. 2022 Feb 7. doi: 10.1002/jmri.28100. Online ahead of print.

ABSTRACT

BACKGROUND: Epicardial adipose tissue (EAT) may induce left atrium (LA) wall inflammation and promote LA fibrosis. Therefore, simultaneous assessment of these two important atrial fibrillation (AF) risk factors would be desirable.

PURPOSE: To perform a comprehensive evaluation of 3D Dixon water-fat separated late gadolinium enhancement (LGE-Dixon) MRI by analysis of repeatability and systematic comparison with reference methods for assessment of fibrosis and fat.

STUDY TYPE: Prospective.

POPULATION: Twenty-eight, 10, and 7 patients, respectively, with clinical indications for cardiac MRI.

FIELD STRENGTH/SEQUENCE: A 1.5-T scanner, inversion recovery multiecho spoiled gradient echo.

ASSESSMENT: Twenty-eight patients (age 58 ± 19 years, 15 males) were scanned using LGE-Dixon. A 5-point Likert-type scale was used to grade the image quality. Another 10 patients (age 46 ± 19 years, 9 males) were scanned using LGE-Dixon and 3D proton density Dixon (PD-Dixon). Finally, seven patients (age 62 ± 14 years, 4 males) were scanned using LGE-Dixon and conventional LGE. The scan time, intraobserver and interobserver variability, and levels of agreement were assessed.

STATISTICAL TESTS: Student’s t-test, one-way ANOVA, and Mann-Whitney U-test were used; P < 0.05 was considered significant, intraclass correlation coefficient (ICC).

RESULTS: The scan time (minutes:seconds) for LGE-Dixon (n = 28) was 5:01 ± 1:40. ICC values for intraobserver and interobserver measurements of LA wall fibrosis percentage were 0.98 (95% CI, 0.97-0.99) and 0.97 (95% CI, 0.94-0.99) while of EAT were 0.92 (95% CI, 0.82-0.97) and 0.90 (95% CI, 0.80-0.95). The agreement for LA fibrosis percentage between the LGE-Dixon and the conventional LGE was 0.92 (95% CI, 0.66-0.99) and for EAT volume between the LGE-Dixon and the PD-Dixon was 0.93 (95% CI, 0.72-0.98).

CONCLUSION: LA fibrosis and EAT can be assessed simultaneously using LGE-Dixon. This method allows a high level of intraobserver and interobserver repeatability as well as agreement with reference methods and can be performed in a clinically feasible scan time.

EVIDENCE LEVEL: 2 TECHNICAL EFFICACY STAGE: 3.

PMID:35128754 | DOI:10.1002/jmri.28100

J Adv Nurs. 2022 Feb 7. doi: 10.1111/jan.15171. Online ahead of print.

ABSTRACT

AIM: To describe Australian registered nurses’ awareness, and implementation of reasonable adjustments within their practice when caring for people with intellectual disability and/or autism. Additionally, the association between key demographic, workforce, and respondent variables and familiarity of the term and regularity of use was explored.

DESIGN: Cross-sectional survey.

METHODS: Survey data were collected between August and October 2020 using an online survey tool. Data were analysed using descriptive and inferential statistics.

RESULTS: Familiarity of the concept of reasonable adjustments was relatively low, compared to respondents who report applying adjustments when caring for people with intellectual disability and/or autism. Higher levels of confidence, comfort, and knowledge when caring for this cohort were associated with greater awareness and application of reasonable adjustments.

CONCLUSION: A higher volume, and diversity in type of, nursing education related to care for people with intellectual disability and/or autism is indicated.

PMID:35128714 | DOI:10.1111/jan.15171

Health Soc Care Community. 2022 Feb 6. doi: 10.1111/hsc.13737. Online ahead of print.

ABSTRACT

Most people living with dementia want to continue living in their own home for as long as possible and many rely on support from homecare services to do so. There are concerns that homecare often fails to meet the needs of clients with dementia, but there is limited evidence regarding effective interventions to improve its delivery for this client group. We aimed to assess whether a co-designed, 6-session dementia training intervention for homecare workers (NIDUS-professional) was acceptable and feasible. Facilitated training sessions were delivered over 3 months, followed by 3, monthly implementation meetings to embed changes in practice. Two trained and supervised facilitators without clinical qualifications delivered the intervention via group video-calls during Oct 2020-March 2021 to a group of seven homecare workers from one agency in England. Participants provided qualitative feedback 3- and 6-months post intervention. Qualitative interview data and facilitator notes were integrated in a thematic analysis. Adherence to the intervention and fidelity of delivery were high, indicating that it was acceptable and feasible to deliver in practice. Thirty of a possible 42 (71.4%) group sessions were attended. In our thematic analysis we report one over-arching theme: ‘Having time and space to reflect is a rare opportunity’. Within this we identified four subthemes (Having time to reflect is a rare opportunity; Reflecting with peers enhances learning; Reflection and perspective taking can improve care; Recognising skills and building confidence) through which we explored how participants valued the intervention to discuss their work and learn new skills. Attendance was lower for the implementation sessions, perhaps reflecting participants’ lack of clarity about their purpose. We used our findings to consider how we can maintain positive impacts of the manualised sessions, so that these are translated into tangible, scalable benefits for people living with dementia and the homecare workforce. A randomised feasibility trial is underway.

PMID:35128740 | DOI:10.1111/hsc.13737

J Med Virol. 2022 Feb 6. doi: 10.1002/jmv.27640. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to investigate the change in Nuclear Factor Erythroid 2-related factor (Nrf2), which plays a critical role in cytoprotection against oxidative stress, in paediatric patients with COVID-19 infection positivity, and to evaluate the relationship between Nrf2 and oxidative balance.

METHODS: The study included 40 children with confirmed COVID-19 infection and 35 healthy children. The groups were compared in respect of Nrf2, total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI), in addition to clinical findings of fever, cough shortness of breath, and contact history, and demographic data of age and gender.

RESULTS: The mean Nrf2 values and TAS levels were determined to be statistically significantly low (p<0.001) and the TOS level and OSI were statistically significantly high in the children with COVID-19 compared to the control group. A significant positive correlation was determined between Nrf2 and TAS (p<0.01); as the Nrf2 value increased, so the TAS value increased. A significant negative correlation was determined between Nrf2 and TOS and OSI (p<0.01); as the Nrf2 value increased, there was determined to be a significant decrease in the TOS and OSI values.

CONCLUSION: COVID-19 infection in paediatric patients causes a decrease in Nrf2 level. By causing a decrease in TAS level and an increase in TOS and OSI levels, the decrease in Nrf2 may explain the tissue damage which can be caused by COVID-19. This article is protected by copyright. All rights reserved.

PMID:35128704 | DOI:10.1002/jmv.27640

Psychophysiology. 2022 Feb 6:e14003. doi: 10.1111/psyp.14003. Online ahead of print.

ABSTRACT

The error-related negativity (ERN) and the error positivity (Pe) are electrophysiological components associated with error processing that are thought to exhibit distinctive developmental trajectories from childhood to adulthood. To investigate the age and age moderation effects on the ERN and the Pe strength during development, we conducted a preregistered three-level meta-analysis synthesizing 120 and 41 effect sizes across 18 group comparison studies and 19 correlational studies, respectively. The meta-analysis included studies with mean age between 3.6 and 28.7 (min-max age range: 3.5 and 49.8) years for age-group comparisons and 6.1 to 18.7 (min-max age range: 4.0-35.7) years for age correlations. Results showed that age was associated with a more negative ERN (SMD = -.433, r = -.230). No statistically significant association between age and the Pe was found (SMD = .059, r = -.091), except for in a group comparison between younger and older adolescents. The age effects were not significantly moderated by whether a Flanker or a Go/No-Go task was used, whereas a probabilistic learning task moderated the age effect on the Pe. Moreover, the Fz and Cz electrode sites yielded stronger negative associations between age and the ERN and the Pe, respectively. The results confirm that the ERN and the Pe show differential development courses and suggest that sample and methodological characteristics influence the age effects, and lay the foundation for investigations of developmental patterns of the ERN and the Pe in relation to psychopathology and early genetic and environmental risk factors.

PMID:35128651 | DOI:10.1111/psyp.14003

J Forensic Sci. 2022 Feb 6. doi: 10.1111/1556-4029.14991. Online ahead of print.

ABSTRACT

Forensic camera device identification addresses the scenario, where an investigator has two pieces of evidence: a digital image from an unknown camera involved in a crime, such as child pornography, and a person of interest’s (POI’s) camera. The investigator wants to determine whether the image was taken by the POI’s camera. Small manufacturing imperfections in the photodiode cause slight variations among pixels in the camera sensor array. These spatial variations, called photo-response non-uniformity (PRNU), provide an identifying characteristic, or fingerprint, of the camera. Most work in camera device identification leverages the PRNU of the questioned image and the POI’s camera to make a yes-or-no decision. As in other areas of forensics, there is a need to introduce statistical and probabilistic methods that quantify the strength of evidence in favor of the decision. Score-based likelihood ratios (SLRs) have been proposed in the forensics community to do just that. Several types of SLRs have been studied individually for camera device identification. We introduce a framework for calculating and comparing the performance of three types of SLRs – source-anchored, trace-anchored, and general match. We employ PRNU estimates as camera fingerprints and use correlation distance as a similarity score. Three types of SLRs are calculated for 48 camera devices from four image databases: ALASKA; BOSSbase; Dresden; and StegoAppDB. Experiments show that the trace-anchored SLRs perform the best of these three SLR types on the dataset and the general match SLRs perform the worst.

PMID:35128659 | DOI:10.1111/1556-4029.14991

Health Serv Res. 2022 Feb 6. doi: 10.1111/1475-6773.13949. Online ahead of print.

ABSTRACT

OBJECTIVE: To develop and test of a measure of patient-centered care (PCC) culture in hospital-based perinatal care.

DATA SOURCES: US perinatal hospitals; 1 provided survey development data and 14 contributed data for survey testing.

STUDY DESIGN: We used qualitative and quantitative methods to develop the Mother-Infant Centered Care (MICC) culture survey. Qualitative methods included observation, focus group, interviews, and expert consultations to adapt items from other settings and create new items capturing dimensions of PCC articulated by The Commonwealth Fund. We quantitatively assessed survey psychometric properties using reliability (Cronbach’s α and Pearson correlation coefficients) and validity (exploratory and confirmatory factor analysis [CFA]) statistics, and refined the survey. After confirming aggregation suitability (ICCs), we calculated “MICC culture scores” at the individual-, unit-, and hospital-level and assessed associations between scores and survey-collected, staff-reported outcomes to evaluate concurrent validity.

DATA COLLECTION: Survey development included 12 site-visit observations, one semi-structured focus group (five participants), two semi-structured interviews, five cognitive interviews, and three expert consultations. Survey testing used online surveys administered to obstetric and neonatal unit staff (N=316).

PRINCIPAL FINDINGS: Using responses from 10 hospitals with ≥4 responses from both units (n=240), the 20-item MICC culture survey demonstrated reliability (Cronbach’s α=0.95) while capturing all PCC dimensions (subscale Cronbach’s α=0.72-0.87). CFA showed validity through goodness-of-fit (overall chi-square=214 [p-value=0.012], SRMR=0.056, RMSEA=0.041, CFI=0.97, and TLI=0.96). Aggregation statistics (ICCs<0.05) justify unit- and hospital-level aggregation. Demonstrating preliminary validity, individual-, unit-, and hospital-level MICC culture scores were associated with all outcomes (satisfaction with care provided, within-unit team effectiveness, and relational coordination [RC] between units) (p-values<0.05), except for neonatal unit scores and RC (p-value=0.11).

CONCLUSIONS: The MICC culture survey is a psychometrically sound measure of PCC culture for hospital-based perinatal care. Survey scores are associated with staff-reported outcomes. Future studies with patient outcomes will aid identification of improvement opportunities in perinatal care.

PMID:35128641 | DOI:10.1111/1475-6773.13949

J Ayub Med Coll Abbottabad. 2021 Oct-Dec;33(4):659-663.

ABSTRACT

BACKGROUND: In January, 2020 COVID-19 infection was declared a public health emergency characterized as pandemic by the World Health Organization (WHO). In March 2020, special guidelines were issued to address mental and psychological aspects of the disease survivors and community at large. This study was conducted with the aim to evaluate the psychological impact of COVID-19 on mothers in the postpartum period.

METHODS: It was cross-sectional study of six months duration on COVID-19 positive deliveries and Covid negative mothers. A total of 84 women (42 Covid Positive and 42 Covid negative) were included through non-probability quota with consecutive sampling technique. Mothers with pre-existing mental health issues, those who had been on medication for any psychological issues or those who suffered from obstetrical and neonatal complications or required transfer to High Dependency Unit (HDU) were excluded from the study. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen the women for postpartum depression. Independent sample t test was used for continuous variables and Fisher exact test was used for qualitative variables.

RESULTS: Mean EPDS score was 9.48±6.33 in COVID-19 positive group. The sub-scale analysis showed mean scores 1.6±1.76 and 4.86±2.94 for Anhedonia and Anxiety with statistically significant difference.

CONCLUSIONS: Women experiencing COVID-19 infection during pregnancy were found to have greater anxiety and nervousness in post-natal period compared to their COVID-19 negative counterparts.

PMID:35124926

J Ayub Med Coll Abbottabad. 2021 Oct-Dec;33(4):664-667.

ABSTRACT

BACKGROUND: The present era has been commanded by ample studies correlating breathing modes & risk of occurrence of malocclusion. The early intervention of altered breathing patterns can head off the long-lasting effects of already established malocclusion. The main intention of this project was to establish the possible correlation between mouth-breathing & malocclusions.

METHODS: Sixty-two (62) patients undergoing orthodontic treatment were evaluated via data form (including history & clinical evaluation). SPSS software version 25.0 was used for data analysis. Patient’s age, gender, type of Angle’s malocclusion & breathing pattern was taken in account while analysing data. Descriptive statistics & Chi- Square test was applied on the data. It was anticipated that mouth breathing is associated with malocclusion. p-value of less than 0.05 was considered to be statistically significant.

RESULTS: A total of 29 males & 33 females participated in the study. The mean age was 13 years (range 6-20 years). A significant correlation was found between mouth-breathing, tongue thrust (p=0.03) & bleeding gums (p=0.006). Other parameters had no significant correlation with mouth-breathing.

CONCLUSIONS: The current study revealed that mouth breathing has significant association with opened mouth at rest & gingival abnormalities (bleeding/ swollen gums) implying that timely diagnosis of such abnormal breathing pattern can hinder with development of altered occlusion & dentofacial conformation.

PMID:35124927